The general objectives of this project will be to lower the morbidity and mortality following severe trauma and to enhance the prospects of prompt recovery following injury. It has been established with the help of the Coroner of the City of San Francisco that two-thirds to three-fourths of all deaths following trauma are the result of respiratory failure, central nervous system injury or infection--often a combination of these. The program director, F. William Blaisdell, and one of the senior investigators, H.B. Fairley, have spent the major portion of their research careers in the study of the etiology and treatment of respiratory failure following critical illness and injury. For this reason, the major thrust developed for this program project will consist of detailed investigation of the factors involved in the etiology, pathophysiology, diagnosis, prevention, and treatment of the Respiratory Distress Syndrome of Shock and Trauma. The resources of our environment, including the research activities of our junior faculty and basic scientist, will be directed toward this objective. The complete Center Grant Proposal contains in addition to this Core Proposal five main projects: Intravascular Coagulation in the Trauma Patient (F.W. Blaisdell), Neurogenic Pulmonary Edema (J. Hoff), Cell Membrane Changes During Shock (D. Trunkey), Role of Parenteral Nutrition in Host Defense Mechanism (G.F. Sheldon), Effect of Trauma on Leucocyte Immunocompetence (C. Miller).